Wonder if you can predict development of clinical RA in those at risk either w/ a - +RF or +CCP - Relevant sxs w/ or w/o abs - 1st deg relatives do RA pts? Abst#1722 shows patterns of pain or degree of jt swelling from SPARRA Qnairre can do so. #ACR20 @RheumNow https://t.co/bQ4ZmSYhBe

Interesting Swedish abstract 1997 at #ACR20. Adjuvant #herpeszoster vaccine (Shingrix) not effective for 25% of JAKi-treated RA pts (n=40) for antibody response (T cell response usually worse, not reported). Is better than nothing good enough? Maybe we need to hold JAKi briefly?

Fantastic session about the 2020 guidelines for management of RA! Soon to be published. One major difference from 2015 guidelines ➡️ Conditional recommendation to choose a Biologic over Triple Therapy in MTX-inadequate responders (Discussion about patient preference is key!) https://t.co/s016piIN7Q

• https://twitter.com/UNMC_Rheum/status/1325840359411343362

Very strong push by #ACR20 to recc MTX in most RA patient scenarios including RA ILD, RA nodules, NAFLD in new RA guidance document @rheumnow

You have a patient with RA on 25 mg MTX SQ, tolerating well without side effects. They have moderate disease activity. Your next step: @Rheumnow. #ACR20

New #ACR RA guidelines is cost conscious: 1. DMARD naive: Preferred MTX over LEF>HCQ/SSZ and preferred MTX over biologic/tsDMARD 2. DMARD naive low DAS: HCQ or SSZ preferred >MTX>LEF 3. T2T goal LDA/remission @rheumnow (thread)

Hepatitis B infexn in RA? Below is the ACR 2020 draft treatment guidelines in this patient population: @RheumNow #ACR20 https://t.co/C3zw4TWOpg

Here is rationale for this recommendation away from triple therapy even though it has not shown to be inferior treatment, but works better/better adherence #ACR20 @Rheumnow. https://t.co/fQPOjLEjoA https://t.co/XrimgQW7oH

• https://twitter.com/ejdein1/status/1325834736569356290

Switching or adding a DMARD in pts w/ moderate-high dz RA activity & hx of previous serious infection w/in the past 12 mos as opposed to starting/increasing GCs is conditionally recommended per draft recs of new ACR RA treatment guidelines. #ACR20 @rheumnow @CCalabreseDO

Draft #ACR20 Rx Recs for RA: MTX is conditionally recommended with NORMAL LFTs and no advanced fibrosis. Role of HCQ for NALFD has been suggested at ACR, but not enough for mod-high disease activity @RheumNow. https://t.co/QFF3BK1NF0